a comparative study of blood glucose measurements using glucometer readings and the standard method in the diagnosis of neonatal hypoglycemia

background: hypoglycemia is one of the most common neonatal disorders, associated with severe complications. there has been a great deal of controversy regarding the definition and screening of hypoglycemia. therefore, in this study, we aimed to determine a cut-off value for blood glucose level in glucometer readings. methods: this cross-sectional study was conducted on 238 newborns at risk of hypoglycemia, admitted to baqiyatallah hospital of tehran, iran in 2012; the subjects were selected via simple sampling. after obtaining informed consents from the newborns’ parents, 1 cc blood samples were sent to the laboratory for measuring the blood glucose level. moreover, venous blood samples, as well as heel-stick blood samples, were obtained for glucometer measurements. blood glucose measurements were used to determine the cut-off value by the receiver operating characteristic (roc) curve and make comparisons with the diagnostic criteria for hypoglycemia in the literature. results: a total of 238 infants with the mean weight of 2869±821.9 g were enrolled in this study. the mean (±sd) blood glucose levels were 65.1±22.9, 82.9±24.7, and 84.4±24.8 mg/dl, based on the standard laboratory method, glucometer reading of venous blood samples, and glucometer reading of heel-stick capillary blood samples, respectively. the optimal cut-off point for hypoglycemia was determined as 65 mg/dl, using glucometer-based assessment of heel-stick blood samples. conclusion: the significant difference in blood glucose levels measured by the laboratory method and outpatient glucometer readings highlights the importance of a cut-off value for rapid assessment and control of blood glucose and timely detection of hypoglycemia. in fact, the cut-off value introduced in the present study could facilitate such measurements.